Medicine and Health Sciences Commons^™

Racial And Ethnic Differences In The Receipt Of Metabolic Syndrome Risk Factor Screening And Treatment Among Prostate Cancer Patients Treated With Androgen Deprivation Therapy., Yazan K. Barqawi

Pharmaceutical Sciences ETDs

Background: Racial and ethnic health disparities in prostate cancer prevalence, incidence, mortality, quality of life, screening, and treatment constitute the largest of all cancer disparities. These health disparities are associated with higher morbidity and mortality rates in minority populations. Treatment with androgen deprivation therapy (ADT) has been the most widely used therapeutic modality to reduce the progression of prostate cancer to a worse disease stage and relieve potential obstructive symptoms. However, ADT is associated with possible toxic metabolic and cardiovascular (CVS) adverse events that may occur within six months of ADT initiation. These adverse events include metabolic syndrome, type II …

Exploring The Role Of Core Positive Selves With Men Convicted Of Child Sexual Offenses: A Character Strengths Initiative, Tiffany A. Miner

Individual, Family, and Community Education ETDs

The aim of this study was to help men convicted of child sexual offenses learn to recognize and engage their character strengths over 12 months. Participants were six men convicted of contact and noncontact (internet) child sexual offenses. All participants were members of a community-based reintegration group for registered citizens. In the first weeks of the study, participants received the Values in Action Inventory of Strengths survey. The survey, containing 240 questions—10 items for each of the 24 character strengths outlined—helped participants identify their top character strengths. The study explored (a) how the men could use their character strengths to …

Estimating The Impact Of Assessment And Treatment Fidelity On Aphasia Treatment Outcomes, Trisha L. Tanaka

Speech and Hearing Sciences ETDs

Purpose: Calls for treatment and assessment fidelity strongly suggest the need to reduce treatment provider and assessor variance surrounding intervention research. The extent to which these sources of variance influence treatment outcomes in aphasia treatment research has yet to be examined. This simulation study sought to explore the relationships between quality of fidelity methods, sample size, power to detect treatment effects, and aphasia treatment effect sizes.

Methods: Individual participant outcomes collected from previous aphasia treatment research studies were used to simulate 200,000 participant outcomes, from which 8,000 sample treatment trials were simulated. Effect sizes were calculated for treatment outcomes related …

Current Issues In Treatment Of Anterior Shoulder Instability: A Review, Ian Power

UNM Orthopaedic Research Journal

Anterior shoulder instability can be problematic in the young, active population, particularly in athletes and military personnel. The shoulder joint is the most frequently dislocated joint, and there is a high rate of dislocation recurrence in younger patients. The stability of the glenohumeral joint is conferred through the bony anatomy and the static and dynamic stabilizers. Recognizing pathological features, identifying glenoid bone loss, and detecting Bankart and Hill-Sachs lesions are key to formulating an appropriate treatment strategy and improving surgical outcomes. Furthermore, the concept of critical bone loss has been refined by looking at subcritical loss. Recent evidence has shown …

Radiographic And Clinical Evaluation Of Syndesmotic Screws In Treating Injuries Of The Distal Aspect Of The Tibiofibular Syndesmosis, James A. Dollahite, Paul J. Goodwyn, Katherine J. Gavin, Richard A. Miller

UNM Orthopaedic Research Journal

Background: Several factors can affect the success of surgical treatment of injuries to the distal aspect of the tibiofibular syndesmosis, including the bony articulation between the distal aspect of the fibula, tibia, and the supporting ligamentous structures; number and size of screws; number of cortices penetrated; and planned routine removal of screws.

Methods: We conducted a retrospective review of radiographs and clinic notes for all patients who underwent open reduction and internal fixation of injury to the tibiofibular syndesmosis, which was performed by a single surgeon (RAM), between January 2011 and December 2014. Only screws were used. The screws were …

Lateral Versus Dorsal Plating For Treating Metacarpal And Phalanx Fractures: A Retrospective Cohort Study, Joshua W. Hustedt, Collin C. Barber, Michael Bonnelli, Lloyd P. Champagne

UNM Orthopaedic Research Journal

Background: The purpose of this study was to investigate the differences between the dorsal and lateral plate position for metacarpal and phalanx fractures.

Methods: We conducted a retrospective review of prospectively collected patient data for 186 fractures treated by a single surgeon between 2009 and 2011. Rates of plate removal, total arc of postoperative motion (TAM), and patient and injury demographics were tested for association with plating position.

Results: Increasing age, larger plates, and dorsal plating were found in univariate analysis to be associated with decreased TAM and increased plate removal in phalanx but not in metacarpal fractures.

Conclusions: These …

Radiographic Prevalence Of Osteoarthritis Of The Scaphotrapeziotrapezoid Joint In Patients With Carpometacarpal Osteoarthritis Of The Thumb: A Retrospective Case Series, Charlotte E. Orr, Robert Mercer, Deana M. Mercer, Drew K. Newhoff, Matthew D. Martin, Moheb S. Moneim

UNM Orthopaedic Research Journal

Background: In planning operative treatment of thumb carpometacarpal (CMC) joint osteoarthritis, surgeons should consider the presence of an arthritic scaphotrapeziotrapezoid (STT) joint. We aimed to determine the radiographic prevalence of concomitant (STT) osteoarthritis with thumb CMC osteoarthritis in patients who underwent surgical treatment at our institution. We hypothesized that the prevalence of concomitant arthritis at these 2 joints (STT and CMC) would be lower than previously reported.

Methods: Between September 2005 and July 2012, a total of 417 patients were identified from our institution using the Current Procedural Terminology code for thumb CMC joint arthroplasty (25447). After applying exclusion criteria …

Transhumeral Amputation For Treating Necrotizing Fasciitis Infection Of The Upper Extremity: Report Of Two Cases, Drew K. Newhoff, Amber L. Price, Christina Salas, Deana M. Mercer

UNM Orthopaedic Research Journal

Necrotizing fasciitis, an infection of the skin and subcutaneous tissue, can spread rapidly. Studies have emphasized the importance of prompt surgical intervention with aggressive debridement of diseased tissue; however, mortality rates are high despite immediate treatment. We describe two men, aged 44 years (case 1) and 74 years (case 2), presenting with necrotizing fasciitis who underwent aggressive surgical intervention, multiple debridements, and eventual transhumeral amputation of the upper extremity. In each case, the patients were discharged from the hospital to their homes on amoxicillin-clavulanate at postoperative days 15 (case 1) and 32 (case 2). Findings of laboratory studies had normalized. …

Rare Tumors Adjacent To The Achilles Tendon: Report Of Two Cases, Jay J. Wojcik, Aditi S. Majumdar, Kathleen M. Madden, Richard A. Miller

UNM Orthopaedic Research Journal

Benign masses are not uncommon near the Achilles tendon of the ankle. However, the occurrence of angiomyomas or glomus tumors in the region has rarely been reported. We describe two patients, a 44-year-old woman and 44-yearold man, who presented with a tender mass posterior to the Achilles tendon. Excision led to successful removal of the lesion in both cases. Results of histological examinations revealed an angiomyoma and glomus tumor in the woman and man, respectively. Although rare, the presence of these tumors should be considered in the differential diagnosis of masses near the Achilles tendon.

Ruptures Of The Quadriceps And Patellar Tendons Of The Extensor Mechanism: A Review, Judd R. Fitzgerald

UNM Orthopaedic Research Journal

Damage to the quadriceps and patellar tendons of the extensor mechanism can be devastating and often life-changing injuries that require prompt diagnosis and treatment. A sound understanding of anatomy, biomechanics, and degenerative changes of both tendons and the extensor mechanism of the knee can help guide surgical repair and postoperative rehabilitation of patients. Immediate primary repair has often resulted in improved postoperative results compared with delayed reconstruction, and the avoidance of gap formation by use of careful techniques and augmentation has been critical for successful treatment. Additionally, patients with extensor mechanism injuries frequently have medical comorbidities or notable tendon degeneration; …

Causes, Evaluation, And Treatment Of Instability Of The Patellofemoral Joint Of The Knee: A Review, Michael J. Hopson

UNM Orthopaedic Research Journal

Instability of the patellofemoral (PF) joint of the knee is typically caused by chronic atraumatic injuries and inciting traumatic events. Anatomically, bony and softtissue structures surrounding the PF joint and extensor mechanism contribute to overall stability of the area, which results in efficient kinematic function at the PF articulation. Furthermore, physiological, genetic, anatomical, and demographical factors may affect the development and progression of PF joint instability. Treatment techniques have varied owing to individual factors that may have influence on pathological features of the injury. Nonoperative treatment has predominantly focused on strengthening of the quadriceps and vastus medialis by coordinated, closed …

Periprosthetic Fractures Of The Femur After Total Hip Arthroplasty And Hemiarthroplasty: A Review, Reilly R. Kuehn

UNM Orthopaedic Research Journal

Periprosthetic fractures of the femur after total hip arthroplasty (THA) and hemiarthroplasty represent relatively uncommon but challenging complications. The incidence of these types of fractures has been rising, owing to an increasing number of hip arthroplasties performed, aging population, and prevalent use of uncemented stems, which may have unsuccessful long-term results compared with use of cemented stems. Method of treatment has been generally based on the Vancouver classification system that describes radiographic characteristics of fractures and stability of the femoral stems in respect to placement in the bone. In particular, the presence of loose stems has often indicated the need …

Treatment Of Injuries And Conditions Of The Distal Clavicle: A Review, Heather M. Menzer

UNM Orthopaedic Research Journal

Several trauma-related injuries and degenerative conditions affect the distal end of the clavicle. Fractures of the distal clavicle and separations of the acromioclavicular (AC) joint are common, resulting from direct impact onto the shoulder region. Osteolysis and osteoarthritis of degenerative processes of the AC joint are caused by repetitive activity and overuse of the shoulder. To help identify options for treating the distal end of the clavicle, this review highlighted notable anatomical locations and biomechanics; findings of physical examinations; classification systems of injuries; and standard operative and nonoperative methods used for treatment. Although distal clavicle fractures, AC joint separations, osteolysis, …

Idiopathic Thrombocytopenic Purpura In A 21-Year-Old Collegiate Football Player: A Case Report, James A. Leinhart, Shane P. Cass, Matthew A. Tennison, Ronica A. Martinez, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Muscle cramps are commonly observed in collegiate athlete-patients; however, the condition may be a symptom of severe disorders. In particular, idiopathic thrombocytopenic purpura (ITP) may be a possible diagnosis and involves a decreased number of platelets in the bloodstream. We describe a 21-year-old collegiate player of American football with initially presented with cramping of the neck, abdomen, and forearms. Although findings of physical examination were normal, results of laboratory tests indicated ITP, and the patient was hospitalized for 3 days until the platelet count increased. Because the levels continued to decrease at 6-month followup, splenectomy and use of rituximab agents …

Spare-Parts Technique For Concurrent Treatment Of Ectrodactyly Of The Feet And Syndactyly Of The Hands In A 2-Year-Old Boy: A Case Report, Brielle K. Payne, Mary E. Logue, Selina R. Silva, Deana M. Mercer

UNM Orthopaedic Research Journal

Syndactyly is the most frequently occurring congenital malformation of the limbs. Although common, few studies have reported treating syndactyly using Z-plasty with and without full-thickness grafting. We present a 2-year-old boy who presented to our clinic with ectrodactyly of the feet and simple complete syndactyly of two fingers on each hand. After ectrodactyly reconstruction, we used the excess foot skin to cover finger defects. The patient recovered well postoperatively, with matching skin and no trouble with hair growth. Use of a spare-parts technique can help avoid complications associated with harvesting grafts from other donor sites. The results reinforce the importance …

Severely Deformed Extraarticular Fractures Of The Scapula: A Review, Sean B. Kuehn

UNM Orthopaedic Research Journal

Nonoperative treatment of severely deformed fractures of the scapula was historically common. However, the findings of newer research have challenged the notion that conservatively managing these fractures results in the most successful outcomes. In an attempt to possibly reveal important indicators for surgical treatment, I reviewed studies on scapula fractures involving scapular anatomy; associated injuries; technological advances that have helped with fracture evaluation; and treatment outcomes between nonsurgical and surgical methods. Although a universally accepted classification scheme of scapula fractures does not exist, use of 3D reconstruction with computed tomography can help define the level and category of fracture deformity. …

Learning The Laprade Technique For Reconstruction Of The Posterolateral Corner Of The Knee, Dustin L. Richter

UNM Orthopaedic Research Journal

No abstract provided.

Treatment Of Full Circumferential Segmental Bone Loss Of The Tibia Resulting From Acute Traumatic Injuries And Complications: A Review, Gregory C. Strohmeyer

UNM Orthopaedic Research Journal

Full circumferential segmental bone loss of the tibia presents a challenge to orthopaedic surgeons. These open fractures often involve extensive soft-tissue damage, which can contribute to poor long-term outcomes even if the tibia is successfully reconstructed. Although amputation was historically used to treat full circumferential segmental bone loss of the tibia because of the severity of the injury, the development of new reconstruction procedures has provided the option of limb salvage techniques. I reviewed studies on treatment of traumatic tibia bone loss, focusing particularly on full circumferential bone loss of greater than 3 cm. Treatment options included amputation, allograft replacement, …

Open Reduction And Internal Fixation For Treatment Of Proximal Humerus Fractures: A Review, Heather K. Woodin

UNM Orthopaedic Research Journal

Fractures of the proximal humerus are common in older patients, and the incidence of these fractures in the United States is expected to notably increase with the aging population. Nonoperative procedures have been preferred in elderly patients with stable fracture patterns to avoid complications associated with osteoporotic bone. However, more complex and unstable fracture patterns often necessitate operative techniques to allow for more anatomical healing. Although proximal humerus fractures have been thoroughly examined, systemized, and studied, no clear method to choosing an appropriate surgical treatment or candidate has been accepted. I reviewed the role of the following factors on successful …

Survey Of Current Articles Published On Total Ankle Arthroplasty And Ankle Fusion, Tony G. Pedri, Richard A. Miller

UNM Orthopaedic Research Journal

In the United States, ankle fusion is more commonly performed than total ankle arthroplasty (TAA) for treatment of degenerative joint disease of the ankle. However, recent advances in implant design and technique have led to a renewed interest in research on TAA. To shed light on current research trends and limited data rather than examine the merits between both methods, we performed a PubMed search of studies on TAA and ankle fusion between January 1, 2009, and January 1, 2015, published in both the American edition of the Journal of Bone and Joint Surgery (JBJS) and Foot & Ankle International …

Third Extensor Compartment Disruption And The Biomechanics Of Thumb Extension, Christina Salas, Drew K. Newhoff, Zainab Cheema, Allison A. Richards, Deana M. Mercer, Amanda K. Medoro, Ahmed M. Afifi, Moheb S. Moneim, John M. Veitch

UNM Orthopaedic Research Journal

Background: Procedures involving release of the third dorsal wrist compartment have been thought to transpose the extensor pollicis longus (EPL) tendon from its anatomical position. Few studies, however, have reported on the effects this might have on function and mechanics of the thumb. We analyzed the impacts of intact extensor retinaculum, release of the third dorsal compartment, and removal of Lister’s tubercle on thumb extension.

Methods: A total of 15 fresh-frozen cadaveric upper extremities (eight male, seven female; mean age, 52 years; range, 38-59 years) were used. For each specimen, three phases of testing were analyzed: the extensor retinaculum was …

Isolated Traumatic Subscapularis Tear In A 12-Year-Old Male Gymnast: A Case Report, Katherine J. Gavin, Gehron P. Treme

UNM Orthopaedic Research Journal

Isolated avulsion fractures of the lesser tuberosity are rarely encountered in younger and older populations. However, because the tendon of the subscapularis insertion is stronger in skeletally immature individuals, isolated tears to the tendon occur more commonly in adults than children and adolescents. Most studies have been limited to case reports that mainly describe traumatic subscapularis tears in adolescent athlete-patients. We present a 12-year-old male gymnast who reported to our clinic with pain and weakness in the right shoulder at 2 months after the initial injury. We performed open repair with suture anchor fixation for treatment of an isolated subscapularis …

Severe Ischemia Of The Finger After Use Of Compressive Self-Adherent Wrap: Report Of Two Cases, Andrea B. Lese, Elizabeth A. Mikola, Deana M. Mercer

UNM Orthopaedic Research Journal

Use of Coban compressive self-adherent wraps (3M, St Paul, MN) has been found helpful in treating various conditions and injuries of the extremities, including lymphedema, edema in burned hands, and sprains or strains. However, the availability and easy application of the wrap have resulted in its common usage with or without adequate instructions. We report two cases in which severe pain and ischemia developed after this bandage was circumferentially applied to a finger to stop bleeding from a simple laceration. One patient required amputation at the level of the proximal interphalangeal joint; the other had resolution of venous congestion symptoms …

Custom-Made Angled Polyethylene Insert Exchange For Treatment Of Valgus Malalignment In Revision Total Knee Arthroplasty: A Case Report, Reilly J. Kuehn, Ch Christopher R Hanosh

UNM Orthopaedic Research Journal

Single- and dual-component revisions have typically been used to correct coronal malalignment after total knee arthroplasty (TKA). However, realignment of well-fixed components can result in complications such as bone loss and the need for increasing constraint of implants. Exchange to a custom-made angled polyethylene insert, although primarily implemented in cases of osteolysis, has been described with low complication rates and minimal loss of motion. We describe a 74-year-old woman who underwent TKA in January 2006 and presented to our clinic in March 2013 with symptoms of pain and instability of the right knee. We performed a revision TKA using two …

Workup And Treatment Of Acute Peripheral Nerve Injuries: A Review, Scott D. Evans

UNM Orthopaedic Research Journal

Peripheral nerve injury (PNI) can be a devastating and life-changing condition, normally caused from traumatic and iatrogenic events. Proper treatment of PNI remains difficult, with less than half of surgical procedures resulting in good or excellent outcomes. Subsequently, physicians should be aware of important principles that can help with management of acute PNI. I reviewed studies on PNI involving anatomy and classification schemes; workup such as electrodiagnostic tests, imaging procedures, and surgical indications; and operative treatment options (including nerve repair and use of nerve grafts and conduits, and nerve, muscle, and tendon transfers). Although treatment of these injuries continues to …

Dupuytren’S Disease: Past, Present, And Future, Nathan T. Morrell

UNM Orthopaedic Research Journal

No abstract provided.

Treatment Of Hallux Valgus With A Chevron Osteotomy Combined With A Lateral Release, Selina Silva, Richard A. Miller

UNM Orthopaedic Research Journal

Purpose: Current literature recommends proximal first metatarsal osteotomy for large hallux valgus deformities. Combined distal osteotomy with lateral release can be done and may provide a similar degree of correction. The concern with this technique is disruption of the blood supply to the first metatarsal head. We hypothesized that a chevron osteotomy in conjunction with a lateral release is effective in correcting some larger hallux valgus deformities without causing disruption of the blood supply to the first metatarsal head.

Methods: We reviewed the imaging studies of fortysix cases that underwent a distal chevron osteotomy with lateral release for correction of …

Anatomy Primer Of The Wrist Ligaments, Deana M. Mercer, Moheb Moneim

UNM Orthopaedic Research Journal

No abstract provided.

Treatment Of Severe Ankle Diabetic Neuroarthropathy (Charcot Ankle) With Retrograde Intramedullary Nailing: Report Of Two Cases, Ian Power, Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.

Even Incomplete Bisphosphonate-Induced Femoral Shaft Fractures Are Best Treated With Nailing, Aditi S. Majumdar, Thomas A. Decoster

UNM Orthopaedic Research Journal

No abstract provided.